People waiting for nursing homes taking up many hospital beds: study

Patients waiting for admission to nursing homes occupy a surprisingly large number of hospital beds in Manitoba — many more in a year, for example, than those devoted to pregnancy and child birth, according to a two-year study by a research arm of the U of M’s faculty of medicine.

In a report released this morning, the Manitoba Centre for Health Policy (MCHP) said 16.7 per cent of hospital bed days over a two-year period were taken up by persons who were approved for a spot in a personal care home or awaiting home care or some other placement. The vast majority of these so-called "alternative level of care" (ALC) patients were waiting to get into nursing homes.

Dr. Randy Fransoo, lead author of the report, said it means that many patients in hospitals are "not in the most appropriate place" for the care they need.

"For hospitals, it means that beds may not be available, causing backups in the system such as longer waits for elective (non-emergency) procedures or admissions from the emergency department," Fransoo said.

Researchers studied hospital stays at all 71 Manitoba hospitals -- with a total of about 4,000 beds -- over a two-year period (2009-2011). It describes patients by age, sex, sickness level and income level.

While ALC patients represented only 3.4 per cent of hospitalizations by service type, they tended to remain in hospital much longer, driving up the percentage of hospital bed use dramatically.

In contrast, those admitted to hospital due to child birth, accounted for 26.6 per cent of patients — but only 8.8 per cent of overall hospital bed use because their stays were relatively brief.

ALC use in Manitoba hospitals amounted to 180,000 days of care each year on average. This made it the third leading cause of hospital days used, after medical and surgical hospitalizations, the report said.

Researchers estimated that if the health system could instantly transfer all Manitobans now in hospital who are waiting placement in a personal care home or supportive housing it would free up about 260 hospital beds.

Meanwhile, the study found that nearly 10 per cent of Manitoba hospital beds were taken up treating persons with mental disorders. As with ALC patients, the number of hospitalizations in this category is relatively low (3.9%), but the patients require longer stays, driving up overall use.

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